Understanding Why African Americans Are at Greater Risk for High Blood Pressure
High blood pressure or Hypertension is a condition where the levels of blood pressure increase. According to the Centers for Disease Control and Prevention (CDC), around 47% American adults suffer from high blood pressure (1). Although hypertension can affect adults from different races and ethnicities, it is seen to be more common in African Americans.
According to the American Heart Association, more than 40% Black men and women in America have hypertension (2).
In this article, we will talk more about the risk factors of hypertension and why its prevalence is more in Black people, how to prevent and treat it.
What the Statistics Say about Hypertension in Black People?
In the year, 2017, guidelines were released by the American College of Cardiology and other health organizations for diagnosis, prevention and management of hypertension in American adults (3). The statistics showed that about 54.9% of non-Hispanic Black adults in America met the criteria for hypertension. Whereas, only 47.3% of non-Hispanic white adults met the criteria for high blood pressure hypertension and 36.7% of non-Hispanic Asian adults followed by 34.4% of Hispanic adults. Other than having increased rates of hypertension, increased rate of uncontrolled hypertension was also seen in non-Hispanic Black adults.
In adults who were taking hypertension medications, about 63 % of non-Hispanic Black adults still experienced blood pressure levels above the desired treatment parameter as opposed to only 50.6% of non-Hispanic white adults (3).
Why Is Hypertension More Common in African Americans?
The reason why hypertension is more common in Black Americans is thought to be because of disparities in economic, social and health factors.
In the year 2010, a review was published by the CDC regarding the psychosocial factors contributing to the increased rate of hypertension in Black men (4). This report broadly referred to specifically Black men; however, majority of these factors can be applied to the Black population in general.
Economic Factors: Socioeconomic differences have a profound effect on the healthcare outcomes, more so for people with lower socioeconomic status. A study from 2004 showed that socioeconomic status was more strongly linked with hypertension in Black Americans when compared to white Americans (5). Economic inequality can also cause poorer healthcare outcomes and this will have a significant negative effect on disease and mortality rates. Lack of healthcare accessibility, health insurance coverage and cultural understanding also affects why there is increased rate of hypertension in African Americans.
Social Factors: According to research, there is a link between racism and race-based discrimination and hypertension. Perceived racism commonly causes lower self-esteem and increased stress, both of which can cause increased blood pressure levels. Other than this, personal attitudes and beliefs regarding the health conditions can also affect the diagnosis and treatment of conditions like high blood pressure. Other factors like age, education level and socioeconomic status also affects the health outcomes of Black Americans having hypertension.
Health Factors: There are also other health conditions which increases the risk of chronic conditions like hypertension. This includes increased obesity in African American men which then increases the risk of developing hypertension.
In the end, there are multiple factors that contribute to increased prevalence of hypertension in Black Americans, more so Black men. However, more studies are needed to determine the best way to identify, treat and manage all these risk factors for the present and future African American populations.
What is the Treatment for Hypertension?
Hypertension tends to remain undiagnosed for years without any symptoms, which makes it all the more important to get your blood pressure checked on a regular basis.
Rarely, acute hypertension will cause the following symptoms: severe anxiety, severe headache, dizziness, vision changes, breathlessness, chest pain and nosebleed. All these symptoms warrant immediate medical attention.
If you’ve received a diagnosis of hypertension or high blood pressure, then treatment will consist of lifestyle changes, which is important along with medications.
Medications for treating hypertension work by dilating the blood vessels. Some of the common medicines for treating high blood pressure are:
Diuretics are medicines, which increase urine output by reducing both blood volume and blood pressure and this way the water and salt are excreted.
Angiotensin inhibitors and blockers reduce the production of hormone, which is responsible for narrowing the blood vessels. Angiotensin II receptor blockers (ARBs) stop the receptors from accepting this hormone resulting in improved blood flow and blood pressure.
Alpha- and beta-blockers prevent the narrowing of blood vessels and beta-blockers reduce the force and speed of the heart, which helps in cutting down the blood flow and pressure and improves the levels of blood pressure.
Alpha-blockers and agonists where the Alpha-1 blockers prevent narrowing of the blood vessels by stopping the receptors from taking in certain hormones. Alpha-2 receptor agonists prevent narrowing of blood vessels by stopping the production of adrenaline.
Vasodilators work by dilating the blood vessels, which will lead to increased blood flow and help in lowering the blood pressure.
Calcium channel blockers treat hypertension by cutting down the strength of the heart’s contraction and this relaxes the blood vessels, which in turn reduces high blood pressure.
Lifestyle Factors for Treating Hypertension in African Americans
There are some lifestyle habits when used along with medications are extremely effective in treating high blood pressure. Sometimes, lifestyle modifications are enough to normalize the increased blood pressure without needing any medication.
The lifestyle changes which help in reducing high blood pressure are: Regular exercise, consuming a heart-healthy diet and managing weight.
Is there any way to Prevent Hypertension in Black People?
The following healthy habits greatly help in preventing hypertension in not only African Americans, but also everyone in general:
Maintaining weight in normal limit helps in preventing hypertension, as obesity or being overweight are a major risk factor for developing high blood pressure.
Eating a balanced diet comprising of vegetables, fruits whole grains, lean meats, and potassium-rich foods helps in cutting down the risk of hypertension.
Increased physical activity for about half an hour to one hour daily helps in reducing the risk of hypertension and other diseases.
Limiting salt intake helps in preventing hypertension, as sodium has a negative effect on blood pressure. The American Heart Association recommends sodium intake of 1,500 mg in a day for good heart health (6). Increasing the intake of potassium also helps in excreting the excess sodium from the body.
Cutting down on alcohol intake and quitting smoking helps in reducing the risk of hypertension and other cardiovascular diseases.
Conclusion
Hypertension is one of the common health afflictions affecting millions of Americans across the country. While hypertension does not essentially discriminate; it, however, is seen to disproportionately affect African American men and women more. The cause for this is multifaceted and includes economic, social and health-related factors all of which contribute to increased prevalence of chronic conditions, such as hypertension, in African Americans.
